The effect of religious coping on caregiving appraisals of mothers of adults with developmental disabilities

Exploring spiritual/religious coping strategies among mothers of children with severe or profound intellectual disability during genetic counseling in Brazil

Parents use several coping strategies to deal with the challenges of caring for children with disabilities. This qualitative study explored the spiritual/religious coping strategies adopted by Brazilian mothers of children with severe or profound intellectual disabilities who were attending the medical genetics clinic for genetic counseling. Individual semi-structured interviews were conducted with 15 participants, selected by convenience. Thematic content analysis was used to investigate the data. Five major themes were recognized: (1) spirituality/religion as a source of resilience; (2) surrender to God's plan; (3) a feeling of predestination; (4) children with a disability perceived/conceived as a blessing; and (5) pleading for divine intervention. Participants highlighted the ability to recover and adapt to bad circumstances and stressful events with God's support using spiritual/religious resources and practices. They attributed the cause and control of events in their lives to an external and transcendental source, showing themselves to be resigned to the condition of their child with a disability and his/her demands. The feeling of predestination appeared as a form of divine intervention as well as a way of attributing meaning to the situation. Their child with a disability was compared constantly to an "angel," a celestial being created by God to be a messenger and fulfill divine purposes. From the participants' perspective, these coping mechanisms appeared to have helped them adjust to the situation. Spirituality and religiousness have become crucial in cultures such as Brazil, where religious practices, often highly syncretic, are common. A more detailed and comprehensive understanding of how spiritual/religious coping strategies are mobilized during the genetic counseling process can improve the cultural competence of genetic counselors and help guide proposals for more effective clinical interventions.

Vietnamese-American family caregivers of persons with mental illness: Exploring caregiving experience in cultural context

While involvement of family caregivers can play an important role in the recovery process of persons with serious mental illness (SMI), family caregivers often endure poor health and mental health issues due to caregiving-related distress. These challenges may be exacerbated for Vietnamese American families due to cultural values (e.g., familism and stigma). This qualitative exploratory study examined how Vietnamese American family caregivers of persons with SMI describe their caregiving experience. Using convenience and snowball sampling, the study recruited 21 participants who took part in two Vietnamese-language focus groups. Key findings of the study addressed three themes: (1) the influence of cultural and religious values on caregiving and mental health; (2) the negative impact of caregiving on caregivers' wellbeing; and (3) the stigma attached to mental illness. The study offers useful insights to assist mental health practitioners in tailoring culturally appropriate and effective services for Vietnamese caregivers.

A qualitative study about quality of life in Brazilian families with children who have severe or profound intellectual disability

BACKGROUND

This study investigated the psychocultural perspectives concerning family quality of life among Brazilian families with children who have severe or profound intellectual disability.

METHODS

Individual in-depth semi-structured interviews conducted with 15 mothers, selected by convenience, were analysed using a categorical thematic analysis technique. The themes were examined to allow for an interpretative approach of the results.

RESULTS

Mothers revealed that their children with disabilities had insufficient access to services and support related to health care, transportation and recreation. Family quality of life was negatively affected by financial restrictions and social interaction difficulties. Caring for a child with disabilities seemed to be centred on the mother and religious coping appeared as a common psychological adjustment strategy.

CONCLUSIONS

Improving emotional and psychological cares, as well as social and practical measures comprising income support and access to appropriate health care, were inferred to be the mothers' priorities to improve their families' quality of life.

Caregiving, intellectual disability, and dementia: Report of the Summit Workgroup on Caregiving and Intellectual and Developmental Disabilities

INTRODUCTION

A specially commissioned working group produced a report on caregiving, intellectual and developmental disabilities (IDDs), and dementia for the National Institutes of Health-located National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers.

METHODS

Experts in caregiving, dementia, and IDDs examined the current state of research, policy, and practice related to caregiving and supports; identified the similarities and dissimilarities between IDD-related care and services and the general population affected by dementia; and considered how these findings might contribute to the conversation on developing a dementia care research and services development agenda.

RESULTS

Five major areas related to programs and caregiving were assessed: (1) challenges of dementia; (2) family caregiving interventions; (3) supportive care settings; (4) effects of diversity; and (5) bridging service networks of aging and disability.

DISCUSSION

Recommendations included increasing supports for caregivers of adults with IDDs and dementia; increasing research on community living settings and including caregivers of persons with IDDs in dementia research; acknowledging cultural values and practice diversity in caregiving; increasing screening for dementia and raising awareness; and leveraging integration of aging and disability networks.

[Impact of moderate intellectual disability on the dynamics and quality of family life: a qualitative clinical study]

This qualitative clinical study investigated the impact of moderate intellectual disability on family dynamics and quality of life. The data were collected using individual interviews with 15 mothers of children with intellectual disabilities, as a convenience sample, and examined with categorical thematic content analysis. The results were discussed using a comprehensive and interpretative approach. Analysis of the interviews showed that care for children with intellectual disabilities is centered on the mother, contributing to the change in family relations. Religious coping appeared as a common strategy for adjusting. Children with intellectual disabilities had less access to services and support than they needed in the areas of health, education, and leisure. Financial constraints and difficulties in community living had a negative impact on the quality of family life. Emotional and psychological support for all the family members, and practical and social support, including income distribution and access to adequate services, proved essential for the well-being of children with intellectual disabilities and their families.

Religiosity, race/ethnicity, and alcohol use behaviors in the United States

BACKGROUND

Religiosity is a protective factor against many health problems, including alcohol use disorders (AUD). Studies suggest that religiosity has greater buffering effects on mental health problems among US Blacks and Hispanics than Whites. However, whether race/ethnic differences exist in the associations of religiosity, alcohol consumption and AUD is unclear.

METHOD

Using 2004-2005 NESARC data (analytic n = 21 965), we examined the relationship of public religiosity (i.e. frequency of service attendance, religious social group size), and intrinsic religiosity (i.e. importance of religious/spiritual beliefs) to frequency of alcohol use and DSM-IV AUD in non-Hispanic (NH) Blacks, Hispanics and NH Whites, and whether associations differed by self-identified race/ethnicity.

RESULTS

Only public religiosity was related to AUD. Frequency of religious service attendance was inversely associated with AUD (NH Whites β: -0.103, p 0.05) or Hispanics (β: -0.002, p > 0.05).

CONCLUSIONS

US adults reporting greater public religiosity were at lower risk for AUD. Public religiosity may be particularly important among NH Blacks, while intrinsic religiosity may be particularly important among NH Whites, and among Hispanics who frequently attend religious services. Findings may be explained by variation in drinking-related norms observed among these groups generally, and in the context of specific religious institutions.

Religion involvement and quality of life in caregivers of patients with schizophrenia in Latin-America

The aim of the study was to explore the relationship between religious involvement (RI) and quality of life (QoL) in caregivers of patients with schizophrenia, while adjusting for key confounding factors such as socio-demographic and clinical characteristics. This study was conducted in the public mental health services in Bolivia, Peru and Chile. The data collected included RI, socio-demographic information, clinical characteristic of the patients and caregiver's QoL using the S-CGQoL questionnaire. A multivariate analysis using multiple linear regressions was performed to determine variables potentially associated with QoL levels. Two hundred and fifty-three patients with their caregivers participated in the study. Caregivers' RI was not significantly associated with overall QoL nor its individual components. The only exception was an unexpected modest inverse association between RI and one QoL dimension (psychological and physical well-being). In contrast, the following caregivers' socio-cultural and economic factors were significantly associated with low QoL level of caregivers: being a mother, identifying with Aymara ethnicity and having lower family income. Among patients, the clinical characteristics of being woman, younger, and having lower age of onset and more severe symptoms was associated with lower QoL. Our study found that socio-cultural, economic and clinical factors were associated with caregivers' QoL.

Religion, Spirituality, and Ethnicity

Caregivers of persons with Alzheimer's disease (AD) provide an inordinate and escalating level of care. It has been postulated that: (1) religious beliefs and/or spirituality may assist individuals in their caregiving efforts; and (2) coping strategies may vary depending on ethnicity. The intent of this pilot study was to examine these theories by interviewing five African-American and five white caregivers of persons with AD using demographic and open-ended questions regarding spirituality, religious practices, and ethnicity. Five themes were identified regarding the development of the caregivers' beliefs and practices: 1. later life development of beliefs; 2. religious training and practices; 3. family influences; 4. impact of ethnicity on caregiving; and 5. impact of spirituality and religion on caregiving.

All caregivers felt their spirituality and/or religious practices shaped how they approached providing care and all reported that they were influenced by their ethnic background. Most stated that religious practices and spirituality affected how they felt about providing care and that religion and spirituality helped them deal with difficult challenges. Through a better understanding of the importance of different coping mechanisms among caregivers, professionals are able to provide more sensitive care to persons of diverse groups.

Socioeconomic Differences in the Effects of Prayer on Physical Symptoms and Quality of Life

The extent to which religiosity is related to well-being may differ as a function of race/ethnicity, education or income. We asked 155 caregivers to complete measures of religiosity, prayer, physical symptoms and quality of life. Lower education and, to a lesser extent, lower income were correlated with religiosity and prayer. There were few direct relationships of religiosity and prayer with quality of life and health symptoms. However, the relationships became significant when education and, to a lesser degree, income were taken into account. Prayer was associated with fewer health symptoms and better quality of life among less educated caregivers.

Individual, parent and social-environmental correlates of caregiving experiences among parents of adults with autism spectrum disorder

INTRODUCTION

Compared to parents of adults with other types of disabilities, parents of adults with autism spectrum disorder (ASD) experience worse well-being. Thus, it is crucial to identify the individual, parent and social-environmental correlates of caregiving experiences among parents of adults with ASD.

METHOD

For this study, 130 parents of adults with ASD responded to a survey about caregiving satisfaction, self-efficacy and burden.

RESULTS

Greater future planning and community involvement related to more caregiving satisfaction and increased caregiving self-efficacy, respectively. Less choicemaking of the adult with ASD related to greater caregiving satisfaction and self-efficacy. Maladaptive behaviours and poor health of the adult with ASD related to greater caregiving burden.

CONCLUSIONS

Implications for policymakers, practitioners and future research are discussed.

Strength and stress: Positive and negative impacts on caregivers for older adults in Thailand

Aim

To understand the experiences of caregivers with older people living in Thailand, particularly as related to quality of life and stress management.

Method

In‐depth interviews with 17 family caregivers were conducted and then data were thematically analysed.

Results

Carers experience not only negative impacts but also positive impacts from caregiving. Negative impacts include emotional stress, financial struggles and worry due to lack of knowledge. Positive impacts include affection from care recipients, good relationships with caregivers before needing care themselves and encouragement from the wider community. Opportunities to show gratitude, build karma (from good deeds) and ideas shaped largely by Buddhist teachings result in positive experiences. Negotiating between the extremes of bliss and suffering and understanding suffering as a part of life may help carers manage their stress.

Conclusions

Temples and centres for older people could be engaged to develop caregiving programs.

Longitudinal perspectives of child positive impact on families: relationship to disability and culture

This study examined mothers' perceptions of the positive impact of having a child with an intellectual disability. Trajectories of positive impact from 7 time points were developed using latent growth modeling and 2 predictors: culture (Anglo, Latino) and child disability status (intellectual disability, typical development). Data were from 219 mothers of children from age 3 to 9 years. Growth trajectories reflected a general decline in positive impact on Anglo mothers. On average, at age 3, Anglo mothers reported significantly lower initial values on positive impact when their children had an intellectual disability, but Latino mothers did not. Across all time points, Latino mothers had higher scores on the positive impact, regardless of whether they had a child with an intellectual disability or a typically developing child.

Exploring the relationship between religious service attendance, mental disorders, and suicidality among different ethnic groups: results from a nationally representative survey

BACKGROUND

To date, sufficient data have not been available to examine ethnic differences in religiosity and mental health in the general population. However, evidence exists to suggest that the protective effects of religion may differ across ethnic groups. This study examined the relationship between religious attendance and mental health across ethnic groups.

METHODS

The Collaborative Psychiatric Epidemiologic Survey (N = 20,130) is a large, ethnically diverse sample of adult, US respondents. Frequency of attendance at religious services was measured as: at least once per week (reference group), one to three times per month, less than once per month, or less than once per year. Multiple logistic regression analyses examined associations between religious attendance and mood, anxiety and substance use disorders, as well as suicidal ideation and attempts. Models adjusted for sociodemographics and comorbidity.

RESULTS

Results differed when performed within each ethnicity. Infrequent religious attendance was associated with substance use disorders in Whites and Africans only (Adjusted Odds Ratio (AOR) = 2.30 [95% CI = 1.77-2.99]; AOR = 1.86 [1.25-2.79], respectively), and with anxiety and suicidal ideation in Whites (AOR = 1.44 [1.10-1.88]; AOR = 1.58 [1.24-2.01]) and Hispanics only (AOR = 2.35 [1.17-4.73]; AOR = 1.70 [1.15-2.52]). Asians were the only group in which religious attendance was associated with mood disorders (AOR = 4.90 [1.54-15.60]). Interaction terms were nonsignificant.

CONCLUSIONS

The present study suggests that ethnicity is an important variable to consider in the relationship between religiosity and mental health. Future studies should attempt to either adjust for or stratify by ethnicity when examining these relationships.

Doing Good and Feeling Good Among African Americans

Previous studies of religion’s role in the connection between helping and well-being among African Americans have examined this relationship from a stress and coping theoretical standpoint, perpetuating a deficit model of positive functioning. In an effort to develop the literature, the authors approached the study of these relationships from a role identity theoretical standpoint, and a fulfillment perspective within a community sample of African American adults ( N = 140). Consistent with tests for mediation, the authors found support for the following: (1) helping positively predicted satisfaction, (2) subjective religiosity positively predicted helping, (3) subjective religiosity positively predicted satisfaction, and (4) the strength of the relationship between subjective religiosity and satisfaction was significantly reduced in the presence of helping. Findings point to a mediation effect for subjective religiosity and to role identity theory as a viable explanation for religion’s role in the relationship between helping and well-being among African Americans.

Aging in place: evolution of a research topic whose time has come

Over the past 30 years, policy makers and professionals who provide services to older adults with chronic conditions and impairments have placed greater emphasis on conceptualizing aging in place as an attainable and worthwhile goal. Little is known, however, of the changes in how this concept has evolved in aging research. To track trends in aging in place, we examined scholarly articles published from 1980 to 2010 that included the concept in eleven academic gerontology journals. We report an increase in the absolute number and proportion of aging-in-place manuscripts published during this period, with marked growth in the 2000s. Topics related to the environment and services were the most commonly examined during 2000-2010 (35% and 31%, resp.), with a substantial increase in manuscripts pertaining to technology and health/functioning. This underscores the increase in diversity of topics that surround the concept of aging-in-place literature in gerontological research.

Fear of death, mortality communication, and psychological distress among secular and religiously observant family caregivers of terminal cancer patients

Previous research suggests that caregivers and terminally ill patients face substantial difficulties discussing illness and death. Existing research, however, has focused primarily on the experience of patients. The current study compared responses as well as the relative strength of association between mortality comunication, fear of death, and psychological distress (i.e., depressive symptomatology, emotional exhaustion) among secular and religiously observant family caregivers of terminally ill cancer patients. A total of 236 participants were recruited over 18 months within the first year of caregiver bereavement. Retrospectively reported mortality communication was statistically greater among secular caregivers; in contrast, both fear of death and depressive symptoms were greater among the religiously observant. Path analyses subsequently revealed notable differences between groups. Among secular caregivers, a significant inverse relationship between mortality communication and the two indices of caregiver distress emerged. In contrast, the association between mortality communication and psychological distress among the religious was moderated by these caregivers' fear of death. The results of this study suggest that fear of death is a significant predictor of psychological distress among religiously observant caregivers of terminal cancer patients (i.e., fear of their own death as elicited by the caregiving role). Fostering morality communication between secular caregivers and patients would appear to be one means of reducing the likelihood of clinically significant psychological distress. This may be insufficient among religiously observant caregivers, however, for whom fear of death may first need to be redressed.

Determinants of the burden and positivity of family caregivers of terminally ill cancer patients in Korea

OBJECTIVE

Caregivers may experience positive or negative feelings about their role. The study investigated the determinants of the burden and positivity of family caregivers of Korean terminal cancer patients.

METHODS

A multicenter cross-sectional survey was conducted with 139 family caregivers. Determinants of caregiver's burden and positivity were assessed by the Caregiver Reaction Assessment Scale and by three questions based on a previous study, respectively. Two separate hierarchical multiple regression models were used.

RESULTS

Each domain of the caregiver's burden and positivity was explained by different factors, with the total explained variance ranging between 14.4-33.6% and 2.6-18.3%, respectively. Caregivers who were unmarried, less educated, and/or had low incomes were more likely to be negatively affected, while those who shared caregiving responsibilities were less prone to negative consequences. Caregivers who were male, religious practitioners, and who perceived a higher burden of schedule disruptions were more likely to have a positive perception of their role, while those who perceived a lack of family support were less likely.

CONCLUSIONS

Our results highlight the importance of sharing the caregiving burden with the other family members. Organizing a family meeting can provide an opportunity for other family members to acknowledge the feelings and reactions of the primary caregivers, and can prompt the sharing of caregiving responsibilities.

Private prayer among Alzheimer's caregivers: mediating burden and resiliency

This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

Religious and spiritual involvement among older african americans, Caribbean blacks, and non-Hispanic whites: findings from the national survey of american life

OBJECTIVES

The purpose of this study was to examine similarities and differences in religious involvement among three groups of older adults-African Americans, Caribbean Blacks, and non-Hispanic Whites.

METHODS

We used data from the National Survey of American Life, a nationally representative household study of African Americans and Caribbean Blacks with a national sample of non-Hispanic Whites who reside in areas (census tracks and block groups) at least 10% African American. We examined demographic correlates of 16 measures of organizational, nonorganizational, subjective religiosity, as well as religious coping and spirituality.

RESULTS

The findings indicated that older African Americans and Caribbean Blacks reported higher levels of religious participation, religious coping, and spirituality than older Whites. We observed few significant differences between older African Americans and older Caribbean Blacks. Gender, age, marital status, income, education, marital status, and region all exhibited significant influences on religious participation and spirituality.

DISCUSSION

Racial groups within the older population present distinctive profiles of religious participation and spirituality. The demographic correlates of religious involvement and spirituality are consistent across a variety of diverse dimensions and measures.

Religious coping among caregivers of terminally ill cancer patients: main effects and psychosocial mediators

This study investigated the association between religious coping, mental health and the caring experience, as well as potential explanatory mechanisms, among 162 informal caregivers of terminally ill cancer patients. Regression analyses indicated that, controlling for socio-demographic variables, more use of positive religious coping strategies was associated with more burden, yet, also more satisfaction. In contrast, more use of negative religious coping strategies was related to more burden, poorer quality of life and less satisfaction, and correlated with an increased likelihood of Major Depressive Disorder and anxiety disorders. In a number of models, negative religious coping was related to outcomes through its relationship with social support, optimism and self-efficacy. Implications for research and healthcare are discussed.

Religion, spirituality and the well-being of informal caregivers: a review, critique, and research prospectus

The purpose of this article is to review and critique the published literature examining the relationships between religion/spirituality and caregiver well-being and to provide directions for future research. A systematic search was conducted using bibliographic databases, reference sections of articles, and by contacting experts in the field. Articles were reviewed for measurement, theoretical, and design limitations. Eighty-three studies were retrieved. Research on religion/spirituality and caregiver well-being is a burgeoning area of investigation; 37% of the articles were published in the last five years. Evidence for the effects of religion/spirituality were unclear; the preponderance (n = 71, 86%) of studies found no or a mixed association (i.e., a combination of positive, negative, or non-significant results) between religion/spirituality and well-being. These ambiguous results are a reflection of the multidimensionality of religion/spirituality and the diversity of well-being outcomes examined. They also partially reflect the frequent use of unrefined measures of religion/spirituality and of atheoretical approaches to studying this topic. Investigators have a fairly large number of studies on religion/spirituality and caregiver well-being on which to build. Future studies should be theory driven and utilize psychometrically sound measures of religion/spirituality. Suggestions are provided to help guide future work.

Family experiences associated with a child's diagnosis of fragile X or Down syndrome: evidence for disruption and resilience

Although previous findings have shown that parents react intensely to the initial diagnosis of their child's disability, studies focused on long-term outcomes and adjustment are needed. We interviewed 21 mothers whose adolescent or young adult was diagnosed with Down syndrome or fragile X syndrome. Qualitative analysis of data focused on the diagnostic process and the child's development revealed emergent themes: importance of context, variations in emotional reactions to the diagnosis, use of specific coping strategies, and changes in family adaptation over time. Results indicate most families experienced elements of disruption and resilience in their reactions to the diagnosis, although different patterns emerged for each syndrome group. Maternal descriptions highlighted positive attributes that contributed to family well-being and behavioral challenges that were a source of family stress.

Health-related stress, affect, and depressive symptoms experienced by caregiving mothers of adults with a developmental disability

The interrelationships among health-related stress, positive and negative affect, and depressive symptoms patterned in the dynamic model of affect (J. Reich, A. Zautra, & M. Davis, 2003) were examined using data from 932 women having an adult child with a developmental disability. Results indicate that women experience a moderate inverse correlation between positive and negative affect under conditions of low levels of health-related stress, whereas at high levels of stress, positive and negative affect become more strongly inversely correlated. Under high-stress conditions, both negative affect and positive affect have a stronger relationship to depressive symptoms than they do under low-stress conditions.

Research in spirituality, religion and aging

Research on the concept of "spirituality" demonstrates its overlap with "religion," so for many purposes they need to be considered together as "spirituality/religion." Investigations of age differences point to the likelihood that spirituality tends to increase during later adulthood. It has important positive relationships with various measures of life satisfaction, psychosocial well-being, and both physical and mental health. It benefits therapy for recovery from illness and is a source of meaning and purpose in life. Spiritual interventions help to relieve psychological distress and death anxiety, as well as the stresses of caregiving. Because of its therapeutic value, prayer is an important resource for coping with problems experienced during the life course. The Spiritual Well-Being Scale and many other instruments have been developed to measure spirituality and related concepts. As in all other domains of research on people, they all have limits and must be applied with caution for both technical and ethical reasons. Nevertheless, applications of the research findings, which overwhelmingly demonstrate the importance of spirituality to human well-being, already are improving the effectiveness of clinical work and social services in all of the health and human service professions. As scientific knowledge of spirituality expands, so does awareness of the need for further research, including the refinement of methodological procedures, expansion to new topics, and extension to international cultures and diverse religions. The outlook for research on spirituality and the consequent practical applications to benefit humanity is very promising.

Religious coping and psychological adjustment to stress: A meta-analysis

A growing body of literature suggests that people often turn to religion when coping with stressful events. However, studies on the efficacy of religious coping for people dealing with stressful situations have yielded mixed results. No published studies to date have attempted to quantitatively synthesize the research on religious coping and psychological adjustment to stress. The purpose of the current study was to synthesize the research on situation-specific religious coping methods and quantitatively determine their efficacy for people dealing with stressful situations. A meta-analysis of 49 relevant studies with a total of 105 effect sizes was conducted in order to quantitatively examine the relationship between religious coping and psychological adjustment to stress. Four types of relationships were investigated: positive religious coping with positive psychological adjustment, positive religious coping with negative psychological adjustment, negative religious coping with positive psychological adjustment, and negative religious coping with negative psychological adjustment. The results of the study generally supported the hypotheses that positive and negative forms of religious coping are related to positive and negative psychological adjustment to stress, respectively. Implications of the findings and their limitations are discussed.

Taoism and its impact on mental health of the Chinese communities

Spirituality and religious coping is an important and rapidly expanding field in recent years. For the Chinese, traditional Taoism may still have a strong impact on the mental health of Chinese people. Taoistic concepts of mental health stress the transcendence from self and secularity, the dynamic revertism of nature, integration with nature and the pursuit of the infinite. Compared with western concepts of mental health, Taoism advocates self-transcendence, integration with the Law of Nature, inaction and infinite frame of reference instead of social attainment, self-development, progressive endeavor and personal interpretation. By means of a case illustration, the writer tries to describe its impacts on help-seeking, stress and coping, and the meaning of life of a Chinese family. Its generalization to different types of Chinese communities is also discussed.

Coping and the course of mother's depressive symptoms during and after pediatric bone marrow transplantation

OBJECTIVE

To evaluate the role of maternal coping strategies in depressive symptoms experienced by mothers of children undergoing bone marrow transplantation (BMT).

METHOD

A total of 207 mothers completed measures of coping and depressive symptoms at the time of the child's BMT, 3 and 6 months post-BMT. The sample was collected between 1998 and 2002. The acceptance rate was 73%. The contribution of demographic, illness and treatment parameters, and mothers' concerns about the child were also evaluated. Growth curve modeling was used to evaluate the role of coping in the course of depressive symptoms. Both main effects and interactions of coping strategies with time of assessment were evaluated.

RESULTS

Acceptance and humor were associated with reductions in maternal depressive symptoms, and planning and alcohol/substance use were associated with increases in maternal depressive symptoms. Positive reframing, use of emotional support, and use of religion were associated with the course of depressive symptoms, but the magnitude of associations differed depending on the use of the coping strategies at the time of transplantation. Mothers' fears about the child also predicted depressive symptoms.

CONCLUSIONS

Acceptance and humor may be targets for behavioral interventions to reduce mothers' depressive symptoms during and after pediatric BMT hospitalization.